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Biomedical subjects

K D Sanders

Publications and source records attributed to K D Sanders.

10 recordsLinked to original sources

Pain in the intensive care unit: recognition, measurement, management.

There has been a resurgence in interest in the in-hospital management of pain, largely related to results of investigations into the role of analgesia in outcome and cost-efficiency. The traditional aim of analgesia as simply an altruistic goal has been supplanted by the goal of impacting on the altered physiology accompanying critical illness and trauma. Elucidation of the effect of pain and the accompanying stress response on pulmonary dysfunction in particular, but also on myocardial ischemia and coagulation, has suggested that the provision of adequate analgesia by time-honored methods may not in itself effect a reduction in morbidity without attention to the method of analgesic delivery and choice of agent.

Journal Article↗

Camphor hepatotoxicity.

We report a case of hepatotoxicity in a 2-month-old baby after a camphor-containing cold remedy was applied dermally. Liver function tests returned to normal after the application of the cold remedy was discontinued. Ingestion of camphor can cause severe liver and central nervous system injury, and neurotoxicity has been observed after exposure to camphor through the skin. Hepatotoxicity after dermal application of camphor has never been reported. This report emphasizes the common use of cold remedies that are usually not beneficial and may be potentially dangerous.

Administration, Cutaneous↗

New records of the blacklegged tick, Ixodes scapularis (Acari: Ixodidae) in Minnesota.

The Minnesota distribution of the blacklegged tick, Ixodes scapularis, was studied during 1998 and 1999. The majority of tick collecting was done by grouse hunters, who sent in specimens collected during the fall of 1998 and 1999. I. scapularis specimens were received from 17 counties, including eight counties in northern and central Minnesota that previously had no reports of I. scapularis. This brings the number of Minnesota counties with reported populations of I. scapularis to 30, mostly in the east-central, central, and northern parts of the state.

Animals↗

Gastric volvulus and wandering spleen.

Although rare in childhood, gastric volvulus and wandering spleen share a common etiology: congenital absence of intraperitoneal visceral attachments. We report an unusual case of a patient who presented with three episodes of intractable vomiting and abdominal mass but no abdominal pain. A diagnosis could not be made until the third episode because the gastric volvulus resolved each time on placement of a nasogastric (NG) tube before any further tests could be done. During the third episode, diagnostic imaging was performed before inserting an NG tube, and the diagnosis of a mesenteroaxial gastric volvulus and an abnormally positioned spleen was made. Although both conditions are caused by abnormalities of fixation, the association of gastric volvulus and wandering spleen has been reported only once before.

Child, Preschool↗

Diarrhea rates and risk factors for developing chronic diarrhea in infant and juvenile rhesus monkeys.

Ten independent risk factors were evaluated in an effort to identify predictors of problem diarrhea at weaning and chronic diarrhea in infant and juvenile rhesus monkeys (Macaca mulatta) at the California Primate Research Center. None of the variables proved to be a significant predictor of problem diarrhea at weaning; however, two of the variables were significant predictors for developing chronic diarrhea. Odds ratios, adjusted for other variables in the logistic regression model, showed that compared with females, males were nearly three times more likely to develop chronic diarrhea, and nursery-reared animals were 7.5 times more likely to develop chronic diarrhea than were breast-fed animals. The annual incidence rates for problem diarrhea at weaning for 1978, 1979, and 1980 were 49%, 37%, and 41%, respectively. A weighted average annual incidence rate for problem diarrhea at weaning for the 3-year period was 39%. The incidence rate for chronic diarrhea for the 3-year period was 49%.

Animals↗

Formulas for older infants.

We explored the possibility that standard infant formulas designed as the sole source of nutrients for small, rapidly growing infants may not be equally suitable for older, larger, and less rapidly growing infants who obtain a portion of energy intake from beikost. Our approach was to consider the probable nutrient intakes of a 6-month-old hypothetic infant receiving 80% of energy intake from a standard formula and 20% from beikost, and nutrient intakes of a 10-month-old hypothetic infant receiving 50% of energy intake from a standard formula and 50% from beikost. The assortment of beikost items consumed by infants is moderately high in protein and low in fat. Calculated nutrient intakes of the 10-month-old hypothetic infant were compared with intakes of infants of similar age in two national surveys. We conclude that standard infant formulas designed for young infants are reasonably well suited to meeting the nutrient needs of infants during the latter half of the first year of life.

Aging↗

Orthotopic liver transplantation in patients with cystic fibrosis.

An 11-year-old boy who had cystic fibrosis underwent an orthotopic liver transplantation. His immediate postoperative course was not unusually complicated when compared with other liver transplant recipients. Transplantation did not correct abnormalities in the sweat test or the respiratory disease. Cholestasis due to obstruction of the recipient duct with tenacious bile was cleared by instilling N-acetylcysteine into the duct. On the 48th day after the transplantation, he died of an intraventricular and intracerebral hemorrhage caused by an Aspergillus brain abscess. We conclude that certain patients with cystic fibrosis may be appropriate candidates for liver transplantation, but their pre- and post-operative management may need to differ from other liver transplant recipients.

Aspergillosis↗

Kupffer cell regulation of fibrinogen synthesis in hepatocytes.

Isolated rat liver macrophages (Kupffer cells) produce a factor(s) which stimulates fibrinogen synthesis 5-8 fold in hepatocyte cultures. The production of the stimulatory factor reached maximum during the first 24 hours the cells were in culture. When the cell culture medium was chromatographed on a calibrated Sephadex G-75 column the major activity peak eluted in the size range of 25,000-30,000 daltons. Taken together these results demonstrate that in addition to their well known phagocytic function, Kupffer cells secrete factor(s) that can significantly increase fibrinogen synthesis.

Animals↗

Growth response to enteral feeding by children with cerebral palsy.

This study evaluated the growth of 51 children with cerebral palsy after the initiation of enteral tube feedings. The children were divided into three groups according to how soon after their central nervous system (CNS) insult they were started on enteral feedings. Group 1 consisted of 14 children who were within a year of their CNS insult; they were underweight for age, but had normal length as well as weight for length. Within 6 months of initiating enteral tube feedings, most children in this group had normalized their weights. Group 2 consisted of 27 children who were within 8 years of their CNS insult; they were stunted and were underweight for both their age and their length. Within 6 months of initiating enteral feeds, the group increased both weight and weight for length to near normal, but their gains in length reached a plateau at 90% of ideal for age. Group 3 consisted of 10 children who were more than 8 years after their CNS insult. This group was severely malnourished but had some improvement in their weight for age and for length but, length for age showed no significant change. We conclude that the earlier adequate nutritional management of children with severe cerebral palsy is initiated, the more readily the nutritional deficits will reverse.

Adolescent↗